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What is sleep apnea?
Sleep Apnea is sleep disorder characterized by repeated stops in breathing for over ten seconds at a time. Obstructive Sleep Apnea (OSA) occurs when the anatomy of the nose, mouth, or throat cause a blockage of air flow into the lungs. Central Sleep Apnea (CSA) occurs when a person's drive to breathe has been decreased, causing repeated cessation of breathing.

What are the effects of sleep apnea?
There are several harmful effects of sleep apnea, beginning with the disturbance of sleep. A person may briefly awaken hundreds of times each night, feeling fatigued in the morning, even though they do not recall any problems during the night. The physical effects of sleep loss go much farther than fatigue alone; sleep deprivation has been shown to worsen inflammation and decrease the effectiveness of certain immune processes. In addition, obstructive sleep apnea can aggravate blood pressure, making it harder to control, perhaps even hastening the development of high blood pressure. There is also a significant increase in the rate of stroke, cardiac arrhythmias, heart attacks, and symptoms of GERD in association with obstructive sleep apnea.

Who is at risk for sleep apnea?
Sleep apnea is currently estimated to occur in 5-7% of the male population and 2-3% of the female population of the U.S., though those numbers are probably low due to under diagnosis and the exclusion of milder (but still medically significant) types of disturbed breathing during sleep. The likelihood of developing sleep apnea increases with age, reaching its peak between the ages of 40-60 years. Disturbed breathing during sleep also accompanies many medical and neurological conditions, deteriorating sleep and further impairing daytime function.

The tendency toward obstructive sleep apnea is greater in men, in part because they have thicker airways (recall the bigger Adam's apple on the front of a man's neck), but also because men have broader necks. There is a significant risk of obstructive sleep apnea with obesity, however symptoms may appear or worsen long before a person appears overweight. Symptoms also increase with the use of sedative medicines or alcoholic beverages in the hours before sleep, because these further relax the throat. Obstructive sleep apnea may also occur in slender people who have a small jaw or a chin that is positioned slightly back.

How is sleep apnea diagnosed?
The most accurate way to diagnose sleep apnea is through an overnight sleep study called a polysomnogram (PSG). This procedure, which simply involves the placement of electrodes and special sensors on the skin to monitor the many physical processes as a patient sleeps.

How is sleep apnea treated?
The most effective treatment of obstructive sleep apnea is the nightly use of a continuous positive airway pressure (CPAP) machine, in which a continuous stream of pressurized room air is sent through a small mask over the nose or mouth, acting as a sort of "air splint" that keeps the airway open. Effective CPAP will completely eliminate snoring and apnea, allowing for continuous breathing and an uninterrupted night of sleep. CPAP may take some getting used to, but with the help of dedicated staff at a sleep center or a respiratory home care company, a person's comfort with the equipment can be improved. Some patients wonder what their spouses will think of the equipment, but most spouses are pleased with the change from snoring and restlessness to a quiet night of sleep.

Some people are helped simply by the use of a dental device that slightly repositions the jaw or tongue. These devices are easily obtained through local dentists, and may be used in addition to CPAP in very severe cases. Using lubricating oral sprays may decrease snoring, but these will not help to treat sleep apnea. Some people improve their breathing with a nasal steroid spray or even a salt water nasal wash; however these approaches are only effective for the mildest of symptoms.

Surgical treatment to change to inside anatomy of the nose, mouth, or throat may be effective for patients who have a clear, isolated area of obstruction causing their sleep apnea. The overall success rate for such surgeries is modest, especially when considered over a longer period of 5-10 years, but there are cases in which a profound improvement in symptoms can be seen.

You can also take a Sleep Apnea quiz by clicking here.

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